Preparing Your Occupational Mix Survey Presented by: R-C - - PowerPoint PPT Presentation
Tennessee HFMA Preparing Your Occupational Mix Survey Presented by: R-C Healthcare Management Services, Inc. K. Michael Webdale Jr., CPA President & CEO Honesty, Integrity and Results You Can Depend On! Agenda General Overview
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– Occupational Mix background – Importance of Occupational Mix – Who has to participate in Occupational Mix Survey? – Survey due dates
– Gathering data
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1886(d)(3)(E) of the Social Security Act requires Centers
years on the occupational mix of employees for each short-term, acute care hospital participating in the Medicare program.
complete the occupational mix survey, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection.
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effect of the hospitals’ employment choices on the wage index”
reflect hospital management decisions rather than geographical differences in the costs of labor”
index reflects only the pure price difference between markets and the nation
index is higher so Occupational Mix controls that effect
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labor have their AHW adjusted downward; those with a cheaper mix of employees and contract labor have their AHW increased
71.5%, so if your RN percentage was greater than that, you received a negative occupational mix adjustment (OMA). If it was less than 71.5%, then the adjustment was a positive OMA
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wage index – Nursing salaries as a percentage of total salaries are the portion of the wage index adjusted by the Occupational Mix Adjustment Factor
Occupational Mix Adjustment Factor (OMAF) that will be applied to the FFY 2019, 2020 and 2021 wage index
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nursing hours
higher percentage
least even the playing field, are the ones most often hurt by it
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Payment System (IPPS) or any hospital that would be subject to IPPS if not granted a waiver – Excluded from the survey
Medicare program before January 1, 2016
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right to apply a penalty for non-response. Currently a non- responding hospital receives its areas average
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State Response Tennessee 96%
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applied to the FFY 2019 – Completed Occupational Mix Survey must be submitted to your fiscal intermediaries, on the Excel reporting form.
– The Excel version of the occupational mix survey can be downloaded from CMS website
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conducted from 1/1/13 to 12/31/13. Third and final year of impact begins October 1, 2017
between January 1, 2016 and December 31, 2016) – They are looking for 26 pay periods without accruals or
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employee categories
contract – RNs – LPNs and Surgical Technologists – Nursing Assistants and Orderlies – Medical Assistants – All Other Occupations
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Occupational Category Paid Salaries Paid Hours Average Hourly Wage (Salaries/Hours) Nursing Occupation RNs LPNs and Surgical Technologists Nursing Assistants and Orderlies Medical Assistants Total Nursing All Other Occupations Total (Nursing and All Other)
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COST CENTER DESCRIPTIONS Lines for 2552-10 Nursing Administration 13 Adults and Pediatrics (General Routine Care) 30 Intensive Care Unit 31 Coronary Care Unit 32 Burn Intensive Care Unit 33 Surgical Intensive Care Unit 34 Other Special Care (specify) 35 Nursery 43 Operating Room 50 Recovery Room 51 Delivery Room and Labor Room 52 Electrocardiology 66 Renal Dialysis 71 Ambulatory Surgical Center (Non-Distinct Part) 72 Other Ancillary 73 Clinics 90 Emergency 91 Observation Beds 92 Note: Subscripted cost centers that would normally fall into one of these cost centers should be included on the survey.
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– Regular, overtime, vacation, holiday, sick, lunch, other paid time off, severance and bonuses
– Regular, overtime, vacation, paid holiday, sick, lunch,
– Overtime hours paid at time and a half should be recorded as one hour – Salaried employees paid a fixed rate should be 40 hours per week or hours actually worked – Do not include non-paid lunch periods, and on-call hours in the total paid hours – No hours are required for bonus pay
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– Highest – California $48.68 AHW $101,260 annual – Lowest – Iowa $26.46 AHW $ 55,040 annual
– AHW - $27.67 – Annual - $57,560
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– Line 11 – Direct Patient Care – Lines 28, 33 and 35 – Contracted A&G, Dietary & Housekeeping – Use amounts paid in calendar year 2016
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– Skilled-nursing facilities, psychiatric, or rehabilitation units
– Part A Teaching Physician, Physician Part B, and CRNAs
– Interns and Residents
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Service-Payment/AcuteInpatientPPS/Wage-Index-Files- Items/FY-2016-Wage-Index-Home-Page.html – Then scroll down for FY 2016 Final Rule AHW Calculator
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Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number MAC # Occ Mix Begin Date Occ Mix End Date step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2015 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2015 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 0.00% $38.823902202 LPN and Surgical Technicians 0.00% $22.767361175 Nursing Assistants and Orderlies 0.00% $15.955866208 Medical Assistants 0.00% $18.006207097 Total Nurse Hours and Salaries $32.875956041 0.0000 0.00% ALLOTHER step 4 0.00% TOTAL Wages (From S-3, Parts II and III) $0 (These are inflated wages, from cell B97 from AHW calculator). THESE 3 LINES, 24, 25, 26, MUST Hours (From S-3, Parts II and III) 0 (Revised hours from cell B98 from AHW calculator). ALSO BE LINKED TO THE 2552-10 Unadjusted AHW 0 (Should match AHW in cell B100 from AHW calculator). SPREADSHEET!! Nurse Occ Mix Wages $0 step 7 All Other Unadjusted Occ Mix Wages $0 step 7 Total Occ Mix Wages $0 step 8 Final Occ Mix Adjusted AHW 0.00000000 step 8 Wage Data from Cost Report You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator Spreadsheet for Final FY 2016 Calculation of Provider Occupational Mix AHW
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Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number MAC # Occ Mix Begin Date Occ Mix End Date step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2015 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2015 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 0.00% $38.823902202 LPN and Surgical Technicians 0.00% $22.767361175 Nursing Assistants and Orderlies 0.00% $15.955866208 Medical Assistants 0.00% $18.006207097 Total Nurse Hours and Salaries $32.875956041 0.0000 0.00% ALLOTHER step 4 0.00% TOTAL Wages (From S-3, Parts II and III) $0 (These are inflated wages, from cell B97 from AHW calculator). THESE 3 LINES, 24, 25, 26, MUST Hours (From S-3, Parts II and III) 0 (Revised hours from cell B98 from AHW calculator). ALSO BE LINKED TO THE 2552-10 Unadjusted AHW 0 (Should match AHW in cell B100 from AHW calculator). SPREADSHEET!! Nurse Occ Mix Wages $0 step 7 All Other Unadjusted Occ Mix Wages $0 step 7 Total Occ Mix Wages $0 step 8 Final Occ Mix Adjusted AHW 0.00000000 step 8 Wage Data from Cost Report You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator Spreadsheet for Final FY 2016 Calculation of Provider Occupational Mix AHW
Fields in PINK are filled in by the provider from the provider's
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Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number MAC # Occ Mix Begin Date Occ Mix End Date step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2015 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2015 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 0.00% $38.823902202 LPN and Surgical Technicians 0.00% $22.767361175 Nursing Assistants and Orderlies 0.00% $15.955866208 Medical Assistants 0.00% $18.006207097 Total Nurse Hours and Salaries $32.875956041 0.0000 0.00% ALLOTHER step 4 0.00% TOTAL Wages (From S-3, Parts II and III) $0 (These are inflated wages, from cell B97 from AHW calculator). THESE 3 LINES, 24, 25, 26, MUST Hours (From S-3, Parts II and III) 0 (Revised hours from cell B98 from AHW calculator). ALSO BE LINKED TO THE 2552-10 Unadjusted AHW 0 (Should match AHW in cell B100 from AHW calculator). SPREADSHEET!! Nurse Occ Mix Wages $0 step 7 All Other Unadjusted Occ Mix Wages $0 step 7 Total Occ Mix Wages $0 step 8 Final Occ Mix Adjusted AHW 0.00000000 step 8 Wage Data from Cost Report You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator Spreadsheet for Final FY 2016 Calculation of Provider Occupational Mix AHW
Fields in PINK are filled in by the provider from the provider's
Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers
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Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number MAC # Occ Mix Begin Date Occ Mix End Date step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2015 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2015 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 0.00% $38.823902202 LPN and Surgical Technicians 0.00% $22.767361175 National Nurse Aides, Orderlies, and Attendants 0.00% $15.955866208 Medical Assistants 0.00% $18.006207097 Total Nurse Hours and Salaries $32.875956041 0.0000 0.00% ALLOTHER step 4 0.00% TOTAL Wages (From S-3, Parts II and III) $0 (These are inflated wages, from cell B97 from AHW calculator). THESE 3 LINES, 24, 25, 26, MUST Hours (From S-3, Parts II and III) 0 (Revised hours from cell B98 from AHW calculator). ALSO BE LINKED TO THE 2552-10 Unadjusted AHW 0 (Should match AHW in cell B100 from AHW calculator). SPREADSHEET!! Nurse Occ Mix Wages $0 step 7 All Other Unadjusted Occ Mix Wages $0 step 7 Total Occ Mix Wages $0 step 8 Final Occ Mix Adjusted AHW 0.00000000 step 8 Wage Data from Cost Report You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator Spreadsheet for Final FY 2016 Calculation of Provider Occupational Mix AHW
Fields in BOLD and/or BLUE are calculated fields-- DO NOT ENTER any information here Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in PINK are filled in by the provider from the provider's
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– Step 1 - Determine % of each subcategory by hours – Step 2 - Multiply each subcategory by National AHW – Step 3 - Determines AHW by subcategory – Step 4 - Sum for Hospital Nursing AHW – Step 5 - Compare Hospital Nursing AHW to National – Step 6 - Calculates Nurse Occ Mix factor – Step 7 - Multiply this by Nursing % to total – Step 8 - Add to “All Other” %
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
step 1 Provider % by Subcategory 67.92% 4.59% 27.17% 0.33%
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
step 2 FY 2011 Final National AHWs by Subcategory $37.435806262 $21.779745192 $15.334363984 $17.232523608
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
step 3 Provider Adjusted AHW 25.425025 0.9999394 4.1658147 0.0561777 30.646956 step 4
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
step 5 Final FY 2011 National Adjusted Nurse AHW $31.852574284
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
step 6 Nurse Occ Mix Adjustment Factor 1.0393
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
in step 7 Provider % by Total 47.74% 52.26%
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 2,500,000 74,000,000 67.92% $37.435806262 25.425025 LPN and Surgical Technicians 169,000 3,200,000 4.59% $21.779745192 0.9999394 Nursing Assistants and Orderlies 1,000,000 14,000,000 27.17% $15.334363984 4.1658147 Medical Assistants 12,000 150,000 0.33% $17.232523608 0.0561777 Total Nurse Hours and Salaries 3,681,000 91,350,000 30.646956 $31.852574284 1.0393 47.74% ALLOTHER 4,500,000 100,000,000 step 4 52.26% TOTAL 8,181,000 191,350,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $72,656,961step 7 All Other Unadjusted Occ Mix Wages $76,526,437step 7 Total Occ Mix Wages $149,183,398step 8 Final Occ Mix Adjusted AHW 47.73868738step 8 Occupational Mix Adjustment 1.9%
$72,656,961step 7 $76,526,437step 7 $149,183,398step 8 47.73868738step 8
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Spreadsheet for Final FY 2013 Calculation of Provider Occupational Mix AHW You Must Fill Out the AHW Calculator Tab Before Filling Out the Occupational Mix Calculator
Fields in PINK are filled in by the provider from the provider's occupational mix spreadsheet Fields in GREEN are filled in from IPPS wage index Web Site or Federal Registers Fields in BOLD and/or Blue are calculated fields--DO NOT ENTER any information here
Provider Information Provider Number FI # Occ Mix Begin Date 1/1/2009 Occ Mix End Date 12/31/2009 step 1 step 2 step 3 step 5 step 6 in step 7 Provider Occ Mix Hours Provider Occ Mix Salaries Provider % by Subcategory FY 2011 Final National AHWs by Subcategory Provider Adjusted AHW Final FY 2011 National Adjusted Nurse AHW Nurse Occ Mix Adjustment Factor Provider % by Total RN 1,000,000 35,000,000 84.46% $37.435806262 31.61808 LPN and Surgical Technicians 170,000 3,000,000 14.36% $21.779745192 3.1271594 Nursing Assistants and Orderlies 14,000 200,000 1.18% $15.334363984 0.1813185 Medical Assistants 0.00% $17.232523608 Total Nurse Hours and Salaries 1,184,000 38,200,000 34.926557 $31.852574284 0.9120 32.59% ALLOTHER 3,800,000 79,000,000 step 4 67.41% TOTAL 4,984,000 117,200,000 Wage Data from Cost Report Wages (From S-3, Parts II and III) $146,433,337(These are inflated wages, from cell B99 from AHW calculator). Hours (From S-3, Parts II and III) 3,125,000(Revised hours from cell B100 from AHW calculator). Unadjusted AHW 46.85866784(Should match AHW in cell B103 from AHW calculator). Nurse Occ Mix Wages $43,527,574step 7 All Other Unadjusted Occ Mix Wages $98,705,065step 7 Total Occ Mix Wages $142,232,639step 8 Final Occ Mix Adjusted AHW 45.51444461step 8
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CBSA NAME WI without OCC MIX OCC MIX Adjustment FY 2017 WI
44 TENNESSEE 0.7192 0.0044 0.7236 16860 Chattanooga, TN-GA 0.8568 0.0129 0.8697 17300 Clarksville, TN-KY 0.7236 (0.0117) 0.7236* 17420 Cleveland, TN 0.7424 0.0606 0.8030 27180 Jackson, TN 0.7236 (0.0068) 0.7236* 27740 Johnson City, TN 0.7236 (0.0082) 0.7236* 28700 Kingsport-Bristol-Bristol, TN-VA 0.7236 0.0055 0.7236* 28940 Knoxville, TN 0.7236 0.0002 0.7236* 32820 Memphis, TN-MS-AR 0.8721 (0.0035) 0.8686 34100 Morristown, TN 0.7236 (0.0082) 0.7236* 34980 Nashville-Davidson--Murfreesboro-- Franklin, TN 0.9222 (0.0045) 0.9177
*Receiving Rural Floor
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patient care
be included in “ALL OTHER” category
administrative or educational
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and medical assistants need to be scrutinized so that they are included in an effort to dilute the RN impact
have any employees who actually do the work of LPN's, aides, orderlies and attendants
clinics
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should be in the “All Other” category
– Include in LPN’s and Surgical Technologists per the instructions
– Exclude if billed under Part B – Instructions say to include in “All Other” if included on S-3
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– Who is preparing the form?
– Pay Periods ending between January 1, 2016 – December 31, 2016 – Contract labor hours – Home office – Related organization
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– mwebdale@rcmgmt.com
– dhanak@rcmgmt.com
Medicare Reimbursement Experts Since 1990